Suprapubic shunt

ABSTRACT

Retention catheter of the expandable wing type, of particular utility as a suprapubic shunt, adapted to be inserted into the bladder through an incision in the lower abdominal wall, characterized by: A. A TROCHAR TUBE HAVING A SLIDABLE STYLET THEREIN WITH A POINTED INNER OR DISTAL END FOR FACILITATING INSERTION THROUGH THE INCISION AND THEREAFTER ADAPTED TO BE RETRACTED INTO THE TUBE TO PREVENT CONTACT WITH AND POSSIBLE DAMAGE TO THE BLADDER, B. RESILIENT WINGS ADJACENT THE DISTAL END, NORMALLY URGED TO EXPANDED POSITION AND ADAPTED TO BE COLLAPSED WHEN THE POINTED STYLET END IS EXTENDED BEYOND THE TROCHAR TUBE, C. A SLIDABLE BUTTON OR FINGER OPERATED MEMBER CARRIED BY THE TROCHAR TUBE FOR MOVING THE STYLET AND ALSO FOR ROTATING A VALVE, COMMUNICATING THE EYE OR OPENING IN THE DISTAL END WITH A CANNULA OR TUBE.

United States Patent Adair 1 1 Jan. 30, 1973 1 SUPRAPUBIC SHUNT Edwin Lloyd Adair, 5985 South Crochet Street, Littleton, Colo. 80120 221 Filed: Aug. 16, 1971 [21] Appl.No.: 171,884

176] lnventor:

[52] US. Cl. ..l28/347,128/242,128/243,

128/349, 128/350 [51] Int. Cl. ..A61b 17/34, A61m 25/00 [58] Field of Search ..l28/349, 347, 350, 243, 241

[56] References Cited UNITED STATES PATENTS 8/1932 Beatty ..128/241 3/1937 Smith ....128/347X 2,556,783 6/1951 Wallace ..l28/349 R 2,616,429 11/1952 Merenlender ..128/350 R 3,397,699 8/1968 Kohl ..128/349 R Primary Examiner-Aldrich F. Medbery AttorneySheridan, Ross & Fields [57] ABSTRACT Retention catheter of the expandable wing type, of particular utility as a suprapubic shunt, adapted to be inserted into the bladder through an incision in the lower abdominal wall, characterized by:

a. a trochar tube having a slidable stylet therein with a pointed inner or distal end for facilitating insertion through the incision and thereafter adapted to be retracted into the tube to prevent contact with and possible damage to the bladder,

b. resilient wings adjacent the distal end, normally urged to expanded position and adapted to be collapsed when the pointed stylet end is extended beyond the trochar tube,

c. a slidable button or finger operated member carried by the trochar tube for moving the stylet and also for rotating a valve, communicating the eye or opening in the distal end with a cannula or tube.

10 Claims, 5 Drawing Figures PATENTEDJAN 30 I973 INVENTOR EDWIN LLOYD ADA/R ATTORNEYS SUPRAPUBIC SHUNT BACKGROUND OF THE INVENTION In a present technique of performing certain operations through the urethral channel, a trochar tube is inserted into the bladder through an abdominal incision through which tube liquid or gas may flow as the operative procedure progresses, thus considerably reducing operative time with its attendant advantages. An example of such type of device is disclosed in my copending application Ser. No. 139,381 now US. Pat. No. 3,692,029 for Retention Catheter and Suprapubic Shunt, wherein a conical tip (42) is disposed on the distal end of the tube which facilitates insertion through the incision. A spring is also employed which places the conical tip some distance from the wings. Also, a valve is employed but this requires removal of the stylet and attachment of a fitting to the proximate end of the trochar tube.

SUMMARY OF THE INVENTION The present invention serves a purpose like that of the device referred to but provides certain improvements thereover, and also provides a device which may be more economically manufactured due to elimination of certain parts. For example, no wing expanding spring is employed, the inherent resilience of the wings now serving the purpose of the spring; the conical tip is an integral part of the stylet and may be retracted to a position inside of the distal end of the trochar tube; and the valve is a part of the device, rather than an at tachment thereto. With the exception of a commercially available and inexpensive O-ring, the device comprises only three parts which may be formed by injection moulding techniques. This simplicity is important when it is considered that the device may be expendable after a single use, obviating dismantling, cleaning, and resterilization, all of which consume valuable time. It is thus contemplated that the device may be furnished, if desired, in a sterile package, used once, and then discarded, analogous to present practice employed in the use of throw-away hypodermic needles. The stylet is also connected to its actuator button and valve with a snap fit which, after being connected, prevents disconnection of these parts, encouraging discard of the device after a single use, rather than an attempt to dismantle for thorough cleaning, which, as will be apparent, is in the interests of always employing an unused and sterile device, which, of course, is possible by reason of the simplicity of parts and low cost of manufacture.

BRIEF DESCRIPTION OF THE DRAWING FIG. I is a longitudinal central section through the subject of the invention;

FIG. 1A is a like section, illustrating a different position of parts;

FIG. 2 is a section taken on line 2-2, FIG. 1;

FIG. 3 is a section taken on line 33, FIG. 1A; and

FIG. 4 is a side elevation of an operating button and valve.

DESCRIPTION OF PREFERRED EMBODIMENT Referring now to the drawing, tro'cha'r tube is of circular configuration formed of plastic material by injection moulding techniques. Angularly spaced wings 12, such as four, are separated by longitudinal slots 14 therebetween and the wings are normally in expanded position as shown in FIG. 1A, tending toremain thereat due to their resiliency. A circular flange 16 is disposed intermediate the ends of the tube to provide an abutment for the forefinger and middle finger of the operator. The proximate end is provided with a cylindrical bore 18 which, on occasion, may communicate with a tube 20 to which a flexible tube or cannula (not shown) may be affixed.

The operating button 22 is provided with a pair of arcuately shaped sliding portions 24,24 which fit the bore and, upon rotation of the button, open or close communication between bore 18 and tube 20. The operating end of the button and valve, which may be engaged by the thumb of the operator, is provided with a member 26 with an integral resilient hinge 28 which urges member 26 radially outwardly. As shown in FIG. 1A, free end 32 of member 26 is disposed in a position where it may abut tube end 34 unless member 26 is depressed to clear same. When so depressed it may then be moved inwardly of the bore, as shown in FIG. 1. An O-ring 36 prevents outward leakage from the bore and around button 22. A pair of resilient lugs 38,38 are integrally formed on button 22, which may spring apart in opposite radial directions. The opening therebetween is cylindrical with a diametrical slot 40 and shoulders 42 are provided adjacent a recess 44 disposed inwardly of the free ends of the lugs.

The proximate end of stylet 46 is provided with a frusto-conical head 48 and a groove 50 adjacent the large end thereof forming a neck portion 52 which rotatably fits within the bore of the lugs. In the assembly of the stylet to lugs 38, the parts are forced toward each other in the axial direction and the taper of the head forces the lugs radially outwardly. When the large end of the conical head reaches the inner end of the lugs they snap back to their original position, thus capturing the head in recess 44. As will be apparent, this is similar to a barb on a hook which permits it to enter but not to retract. After assembly of the two parts they are secured together against a force which would tend to pull them apart. The remainder of the stylet is essentially a circular rod with guiding and supporting fins 56 and a conical distal head portion 58. A

set of angularly spaced and radially extending lugs 60 are provided on the rod near its distal end which slide in slots I4, previously described.

In the operation of the device, member 26 with the stylet in place is first depressed to permit it to enter bore 18 and slide therein. Thumb pressure on the free end of the button then moves the stylet relative to the tube until lugs 60 engage the ends of slots 14. When lugs 60 abut the ends of the slots they then collapse the wings 12, head portion 58 now being exposed and beyond the distal end of the trochar tube. When in this position the trochar tube is inserted through the incision. A slight rearward pull force on the button now releases lugs 60 from the front ends of the slots and the wings expand from the position shown in FIG. 1 to that of FIG. 1A.

When it is desired to communicate slots 14 with tube 20, button 22 is rotated to move one of the arcuate portions 24 out of registry with tube 20.

While the invention has been described for use as a ried thereby for opening and closing communication of suprapubic shunt, communicating with a bladder, it will the bore of the trochar tube with a conduit secured to be apparent that it may be employed with other organs. the trochar tube.

l claim: 5. A device in accordance with claim 4 including 1. A suprapubic shunt, comprising; 5 locking means for preventing movement of the stylet a. an elongated partially flexible trochar tube having e d tip s disposed ithin the distal end of the a bor t ndi f it rear proximate d to trochar tube, and manual means to permit movement its front or distal end, of the stylet to collapse said wings when it is desired to b. a plurality of angularly spaced elongated slots in remove the dcvlce through the incisionthe wall f the tube near its distal end, f i l 6. A device in accordance with claim wherein the a djbl Wings therebetween, locking means, the operating member, and the valve c. a stylet slidably disposed within the trochar tube mentber integrally formed of injection moulded having a converging distal tip, such as conical, said Plastlc matffnal" tip being movable from a position within the distal devlce accortame clam the end of the trochar tube to a position extending [5 locking means IS a radially movable spring having an beyond its distal end and end adapted to abut the proximate end of the trochar tube, the spring, when depressed radially inwardly, permitting the operating member to move axially within the trochar tube.

8. A device in accordance with claim 7 including an O-ring carried by the operating member engageable with a bore in the trochar tube and means adjacent thereto for providing said trochar tube with a selective fluid discharge means. 9. A device in accordance with claim 8 wherein the d. radial extending means carried by the stylet for engaging the trochar tube at a position adjacent the distal ends of said slots for moving said wings to collapsed position,

e. the construction and arrangement being such that when said wings are collapsed adjacent the stylet said tip is extended beyond the distal end of the trochar tube, the tip aiding in inserting the trochar tube through an incision, Such as an incision trochar tube and its wings are integrally formed of inthrough an abdominal wall and into a bladder, and jection moulded material and the stylet is formed as an the tip, when retracted being enclosed within the integral member, the device thus comprising four parts trochar tube preventing its contact with and consisting of: the trochar tube, the stylet, the operating damage to an organ within which it is disposed, member, and the O-ring.

and positioning the wings in extended position. 10. A device in accordance with claim 4 wherein the 2. A device in accordance with claim 1 wherein the proximate end of the stylet is secured to the operating distal ends of said slots provide abutments for said member by a tapered head member on the proximate means. end of the stylet, shaped to enter an aperture in 3, A d i i accordance i h l i 1 i l di resilient lugs on the operating member, upon relative means for resiliently urging said wings toward their exaxial movement toward each Othfif, Said head member panded positions to provide fluid entrance openings. Preventing Separation of the stylet from th@ Operating 4. A device in accordance with claim 1 including an member upon application of an axial force in the P operating member secured to the proximate end f the posite direction, whereby the stylet is irremovable from stylet and slidable and rotatable within the trochar the operating membertube, said member having a rotary valve member car- 

1. A suprapubic shunt, comprising; a. an elongated partially flexible trochar tube having a bore extending from its rear or proximate end to its front or distal end, b. a plurality of angularly spaced elongated slots in the wall of the tube near its distal end, forming expandible wings therebetween, c. a stylet slidably disposed within the trochar tube having a converging distal tip, such as conical, said tip being movable from a position within the distal end of the trochar tube to a position extending beyond its distal end, and d. radial extending means carried by the stylet for engaging the trochar tube at a position adjacent the distal ends of said slots for moving said wings to collapsed position, e. the construction and arrangement being such that when said wings are collapsed adjacent the stylet said tip is extended beyond the distal end of the trochar tube, the tip aiding in inserting the trochar tube through an incision, such as an incision through an abdominal wall and into a bladder, and the tip, when retracted being enclosed within the trochar tube preventing its contact with and damage to an organ within which it is disposed, and positioning the wings in extended position.
 1. A suprapubic shunt, comprising; a. an elongated partially flexible trochar tube having a bore extending from its rear or proximate end to its front or distal end, b. a plurality of angularly spaced elongated slots in the wall of the tube near its distal end, forming expandible wings therebetween, c. a stylet slidably disposed within the trochar tube having a converging distal tip, such as conical, said tip being movable from a position within the distal end of the trochar tube to a position extending beyond its distal end, and d. radial extending means carried by the stylet for engaging the trochar tube at a position adjacent the distal ends of said slots for moving said wings to collapsed position, e. the construction and arrangement being such that when said wings are collapsed adjacent the stylet said tip is extended beyond the distal end of the trochar tube, the tip aiding in inserting the trochar tube through an incision, such as an incision through an abdominal wall and into a bladder, and the tip, when retracted being enclosed within the trochar tube preventing its contact with and damage to an organ within which it is disposed, and positioning the wings in extended position.
 2. A device in accordance with claim 1 wherein the distal ends of said slots provide abutments for said means.
 3. A device in accordance with claim 1 including means for resiliently urging said wings toward their expanded positions to provide fluid entrance openings.
 4. A device in accordance with claim 1 including an operating member secured to the proximate end of the stylet and slidable and rotatable within the trochar tube, said member having a rotary valve member carried thereby for opening and closing communication of the bore of the trochar tube with a conduit secured to the trochar tube.
 5. A device in accordance with claim 4 including locking means for preventing movement of the stylet when said tip is disposed within the distal end of the trochar tube, and manual means to permit movement of the stylet to collapse said wings when it is desired to remove the device through the incision.
 6. A device in accordance with claim 5 wherein the locking means, the operating member, and the valve member are integrally formed of injection moulded plastic material.
 7. A device in accordance with claim 6 wherein the locking means is a radially movable spring having an end adapted to abut the proximate end of the trochar tube, the spring, when depressed radially inwardly, permitting the operating member to move axially within the trochar tube.
 8. A device in accordance with claim 7 including an O-ring carried by the operating member engageable with a bore in the trochar tube and means adjacent thereto for providing said trochar tube with a selective fluid discharge means.
 9. A device in accordance with claim 8 wherein the trochar tube and its wings are integrally formed of injection moulded material and the stylet is formed as an integral member, the device thus comprising four parts consisting of: the trochar tube, the stylet, the operating member, and the O-ring. 